Systemic sclerosis (SS) is an uncommon disease of uncertain etiology in which both genetic and environmental causes are postulated to play a role. However it is hypothesized that the disease is more aggressive in non-Caucasians who manifest a higher occurrence of organ involvement and a worse prognosis. The reasons for this may include genetic factors or organic or behavioral factors. At the three Texas medical centers, cohorts of Caucasians, African American, and Hispanics will be studied from early onset. The study will determine the HLA class II genotypes by DNA oligotyping and disease-associated alleles of other candidate genes found to be associated with SS; determine the sociodemographic parameters and behavioral features of the patients; determine pertinent clinical and laboratory parameters including disease manifestations; follow disease progression to outcomes; and examine the relative contributions and interactions of genetic, demographic, socioeconommic, cultural, familial, and initial clinical and laboratory features on the course and outcome of the disease.